Peer-reviewed veterinary case report
How neutrophil counts affect chemo and side effects in dogs
By Fournier, Q et al.·Published in Journal of veterinary internal medicine·2018·Royal (Dick) School of Veterinary Studies, United Kingdom·View original on PubMed →
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Original publication title: Impact of Pretreatment Neutrophil Count on Chemotherapy Administration and Toxicity in Dogs with Lymphoma Treated with CHOP Chemotherapy.
- Species:
- dog
Plain-English summary
A group of dogs with lymphoma undergoing CHOP chemotherapy had their pre-treatment neutrophil counts (ANC) evaluated to see how it affected their treatment and side effects. It was found that using a cutoff of 1.5 for ANC allowed most dogs to receive their chemotherapy without delays, while higher cutoffs led to more missed treatments. Importantly, dogs with lower ANC levels (between 0.75 and 1.5) recovered on their own without needing extra medical help. This suggests that a lower ANC threshold could be safe and effective for administering chemotherapy in these dogs.
People also search for: dog lymphoma treatment · chemotherapy side effects in dogs · neutrophil count in dogs
Abstract
BACKGROUND: Prechemotherapy absolute neutrophil count (ANC) cutoffs are arbitrary and vary across institutions and clinicians. Similarly, subjective guidelines are utilized for the administration of prophylactic antibiotics in neutropenic dogs. OBJECTIVES: To evaluate the impact of various ANC cutoffs on chemotherapy administration in dogs with lymphoma treated with CHOP chemotherapy and to determine whether an association between prechemotherapy ANC and subsequent toxicity exists. The secondary objective was to evaluate a currently used ANC cutoff to indicate prescription of prophylactic antibiotics. ANIMALS: Dogs diagnosed with lymphoma treated with CHOP chemotherapy (n = 64). METHODS: Six hundred and fifteen ANCs were stratified into 6 classes. The 3 ANC cutoffs 1.5 × 10/μL, 2.0 × 10/μL, and 2.5 × 10/μL were assessed. The presence of an association between prechemotherapy ANC class and toxicity was determined. Afebrile neutropenic dogs with ANC <1.5 × 10/μL but above the criteria for prophylactic antibiotics were evaluated. RESULTS: Chemotherapy was not administered in 7% of visits with an ANC cutoff of 1.5 × 10/μL; chemotherapy would not have been administered in 10% and 16% of visits with an ANC cutoff of 2.0 × 10/μL or 2.5 × 10/μL, respectively. There was no association among the 3 lower prechemotherapy ANC classes and toxicity. All dogs with ANC 0.75-1.5 × 10/μL recovered spontaneously without medical intervention. CONCLUSION AND CLINICAL IMPORTANCE: The number of dose delays was minimized with a prechemotherapy ANC cutoff of 1.5 × 10/μL, and the prechemotherapy ANC class 1.5-1.99 × 10/μL was not associated with an increased toxicity. Further investigation of an ANC cutoff near 0.75 × 10/μL in which to prescribe prophylactic antibiotics is indicated.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/29205493/